Ill and need marijuana? Head south to Rwanda

Sunday April 17 2011

According to the proposed law, the drug will only be administered in health institutions to relieve pain or to treat mental problems. Photo/FILE

It could be the first step in fulfilling the hazy dream of many a reggae artiste.

Marijuana, considered as dangerous as cocaine and heroin in the statute books, remains illegal in all East African countries.

However, this may change. In June last year, Rwanda took the initial steps in legalising marijuana strictly for medical purposes, the first country in Africa to do so.

The proposed law provides that marijuana will only be administered in health institutions to relieve pain or to treat mental problems.

Rwanda’s Minister of Health, Dr Richard Sezibera while presenting the draft law to Parliament, said that the objective of the Bill was to contribute to the protection of the population while “ensuring that drugs and psychotropic substances are exclusively available for scientific and medical purposes”.

If the Bill passes into law, Rwanda will join the ranks of countries such as Belgium and Canada, where, with a doctor’s prescription, patients are allowed to possess a small amount of the drug to alleviate chronic debilitating symptoms such as neuropathic pain and side effects of chemotherapy.


The implications of the move in the region are potentially far-reaching.

It is speculated that with the greater availability of a relatively affordable pain treatment that medical marijuana offers, Rwanda could conceivably become the hospice care capital of East Africa, in a region where specialised care and anti-pain medication for the terminally ill is often out of reach of most patients.

The attempt is not without controversy, however, and it is feared that the assent of the Bill into law could have other unintended spillover effects in the region.

To conservatives, the Bill presents a potential “slippery slope”: an initially innocuous move that could disrupt the drug market in the region, creating a demand that other East African countries — where marijuana remains illegal — would be eager to come in and fill, possibly resulting in the smuggling of the drug into Rwanda from the wider East African region.

Cannabis, often seen as an entry point to hard drugs, remains the most widely used illicit substance in the world.

Globally, the number of people who had used cannabis at least once in 2008 is estimated to be between 129 million and 191 million, or 2.9 per cent to 4.3 per cent of the world population aged 15 to 64.

Worldwide, cannabis seizures amounted to 4,600 metric tonnes in 2008. Cannabis herb is also the most widely trafficked substance in terms of volume and geographical spread.

Figures indicating marijuana use in East Africa are scanty, but according to the 2010 World Drug Report compiled by the UN Office on Drugs and Crime (UNODC), it is estimated between 4.5 million and 9.19 million people in East Africa used the drug at least once in 2008, representing between 3.4 per cent and 7 per cent of the population aged between 15 and 64.

According to the UNODC, in East Africa, fairly large-scale cannabis cultivation occurs in Kenya and Uganda, primarily in the Lake Victoria basin, the Mt Elgon region, in the central highlands around Mt. Kenya and along the coast.

As much as 1,500 hectares of cannabis are estimated to be cultivated in this area, some in the lower farmlands concealed among traditional crops and some in higher altitude areas regarded as national wildlife reserves.

According to official reports, 80 per cent of the cannabis in Tanzania is grown domestically, with 20 per cent being imported from Malawi.

Ninety per cent of locally produced cannabis in Tanzania is consumed locally.

The medicinal use of marijuana is legal in a number of countries including Belgium, Canada, the Netherlands, the Czech Republic, Israel, and 15 states in the US.

No African country has legalised the use of the drug even for medicinal purposes, and jail terms can be as long as 10 years for possession, and 20 years for distribution.

In attempting to legalise the drug strictly for medicinal purposes, Rwanda may well be following in the footsteps of California in the US, where the drug was made legal in 1996 and an entire industry sprouted up around medical marijuana.

There, patients can grow, possess and use marijuana for medicinal purposes, after securing a doctor’s recommendation.

A patient’s primary caregiver may also provide marijuana, though many patients turn to marijuana dispensaries to obtain the drug.

A patient with a note from his or her doctor can also grow up to six plants or possess no more than half an ounce of marijuana.

But individual counties can also set their own regulations, causing some to relax their standards even further.

Because of these relatively liberal regulations, numerous medical marijuana dispensaries operate throughout the state in accordance with state law.

However, growers, dispensaries and other middlemen often come into conflict with the US federal government and federal law enforcement agencies, under whose jurisdiction the drug remains illegal.

In a medical setting, marijuana is used to treat nausea especially as a result of chemotherapy, loss of appetite, chronic pain, anxiety, arthritis, glaucoma, multiple sclerosis, insomnia, epilepsy, inflammation and migraines, among other conditions.

The drug is also used to ease pain and improve quality of life for people who are terminally ill, such as those with cancer and Aids patients.

Critics of the use of medical marijuana often raise the question: Why turn to marijuana for medical reasons when other legal medications are available?

Supporters respond that patients do not simply use cannabis for the “high”.

They argue that laws that authorise marijuana use for medical purposes work on the premise that certain symptoms and diseases can best be treated with marijuana.

Marijuana advocates argue that marijuana has been shown to decrease nausea and increase appetite, which can be essential for cancer and Aids patients who are having difficulty keeping down food or maintaining adequate nutrition.

For glaucoma sufferers, marijuana helps to lower intraocular eye pressure.

Also, some types of pain, such as peripheral neuropathy, respond better to marijuana than conventional pain relievers.

An extensive body of research exists surrounding the medicinal value of marijuana.

Much of it revolves around delta-9-tetrahydrocannabinol (THC), one of the cannabinoids in marijuana.

THC is what causes people to feel “high” and also what gives cannabis some of its medicinal properties, such as increased appetite.

According to a number of papers published by scientific journal Nature, the human body produces endocannabinoids, its own natural version of cannabinoids.

The body will produce endocannabinoids when needed, but most of the time, their effect is very shortlived.

Endocannabinoid receptors are found throughout the body but are especially prominent in the brain.

The cannabinoids in marijuana, like THC, bind to these receptors, producing various effects, some medicinal, such as reducing pain or anxiety, but also the feeling of being high.

Besides its medical uses, research has shown that cannabinoids slow down the development of certain cancers.

Medical research has focused on how to extract the medical benefits of cannabis without producing intoxication.

For example, Marinol is used for treatment of nausea in cancer and Aids patients.

Marinol is considered a legal alternative to marijuana, much in the way that morphine, extracted from opium, is a legal, alternative to smoking opium or heroin.

Nevertheless, the use of Marinol has been deemed less effective and more expensive than marijuana.

According to the US-based lobby group the National Organisation for the Reform of Marijuana Laws, Marinol lacks some of the compounds that make marijuana medically beneficial.

In addition, smoking herbal marijuana provides patients with a faster acting medication.

Marinol may also be more psychoactive than natural cannabis and present its own set of side effects.

Marinol’s oral route of administration is partly for its heightened psychoactivity compared to inhaled cannabis as it is metabolised in the liver into chemicals that can be upto five times more potent than natural THC.